Ocular surface flora and prophylactic antibiotics for cataract surgery in the age of antimicrobial resistance

Profilaktyka zakażeń po operacji zaćmy: fluorochinolony i leki przeciwzapalne – pojedynczo czy w preparatach złożonych?

“…Unfortunately, under-dosing or prolonged use of antimicrobial agents in the treatment or prevention of infections can promote the selection of resistant strains [20]. This is particularly true for the quinolones, as their use is characterized by relatively rapid selection of resistant strains compared to other antimicrobial agents.…”

“…This is particularly true for the quinolones, as their use is characterized by relatively rapid selection of resistant strains compared to other antimicrobial agents. Iwasaki et al demonstrated a significant increase in the MIC values of moxifloxacin and gatifloxacin against Gram-positive bacteria isolated from patients with keratitis in 2014-2016 [20]. Therefore, attention should be paid to the rational use of antimicrobial agents that involves appropriately large doses and keeping the treatment duration to a minimum.…”

Is it time for a moratorium on the use of benzalkonium chloride in eyedrops?

“…Finally, it is also important to consider the effect of BAC on the efficacy of antibiotic therapy. Many studies have shown that exposure to BAC is linked to promoting antibiotic resistance in environmental bacteria and human pathogenic bacteria1 14–16 . Analysis of the ocular microbiota following prolonged treatment with BAC eyedrops showed an increased incidence of methicillin‐ and fluoroquinolone‐resistant bacteria compared to ocular surfaces treated with BAC‐free eyedrops 15 .…”

“…[14][15][16] Analysis of the ocular microbiota following prolonged treatment with BAC eyedrops showed an increased incidence of methicillin-and fluoroquinolone-resistant bacteria compared to ocular surfaces treated with BAC-free eyedrops. 15 Specifically, concerning glaucomatous patients, a 2017 study 17 showed that the incidence of methicillin-resistant Staphylococcus epidermidis in patients treated with BAC-containing prostaglandin analogues increases by approximately 4-fold. Closer analysis of these isolates revealed other susceptibility profiles extended to other antibiotic families such as beta-lactams, aminoglycosides, quinolones and macrolides.…”

“…Many studies have shown that exposure to BAC is linked to promoting antibiotic resistance in environmental bacteria and human pathogenic bacteria1. [14][15][16] Analysis of the ocular microbiota following prolonged treatment with BAC eyedrops showed an increased incidence of methicillin-and fluoroquinolone-resistant bacteria compared to ocular surfaces treated with BAC-free eyedrops. 15 Specifically, concerning glaucomatous patients, a 2017 study 17 showed that the incidence of methicillin-resistant Staphylococcus epidermidis in patients treated with BAC-containing prostaglandin analogues increases by approximately 4-fold.…”